La cataract surgery has undergone a real revolution in the last 20 years, becoming more efficient, safer and faster. In fact, thanks to new surgical techniques, as many as 95% of patients manage to achieve a significant improvement in visual acuity after surgery and in some cases go without corrective glasses altogether. Today, the needs of cataract surgery patients have changed dramatically. Indeed, many adults work beyond retirement age and lead more active lives than in the past. People aged 50 and over devote many hours a day to activities that require good intermediate vision, such as watching TV, using computers, exercising, driving or travelling.
Monofocal intraocular lenses (IOLs) are the most commonly used in cataract surgery. With an optical dish provided with a single focal point, monofocal IOLs are effective in restoring satisfactory distance vision; however, most patients require correction through spectacles for intermediate and near vision, even after surgery.Â
To meet the increasing patient demand for spectacle independence, multifocal IOLs have been developed. However, in order to provide distance, intermediate and near vision at the same time, multifocal IOLs have an optical dish with two or more independent focal points, which results in reduced contrast and increased photic phenomena, with possible negative effects on vision quality. Therefore, the need for monofocal IOLs that significantly improve intermediate vision and can help patients in their daily activities and make their lives easier has arisen. Â
Monofocal IOLs with extended depth of focusÂ
A newly developed type of IOL has recently been introduced, based on the extended depth of focus (EDOF). The principle behind EDOF IOLs is to create a single extended focal point, which can increase the depth of focus, unlike standard monofocal IOLs where light is focused on a single point. Thanks to technological advances, EDOF IOLs have shown excellent results, with less contrast reduction and less photic phenomena. Besides being efficient in providing distance and intermediate vision, EDOF IOLs are safe, with rare serious postoperative complications.
EVOLUXâ„¢a new standard of care with EDOF technologyÂ
The EVOLUX intraocular lensâ„¢ is an extended monofocal IOL with a non-diffractive optical profile, designed to improve intermediate vision and provide a distance vision and safety profile comparable to that of a standard monofocal IOL. The front surface of EVOLUXâ„¢ features patented optics based on spherical aberration technology for effective optical performance and easy handling. Â
The EVOLUX lensâ„¢ causes the 99% of light to be concentrated within a spot of 20 μm, similar to a standard monofocal IOL. Image contrast is, therefore, maintained due to the absence of light dispersion. Furthermore, EVOLUXâ„¢ is tolerant to slight myopic and hypermetropic shifts.Â
Minimal glistening for better optical qualityÂ
I 'glistenings' are liquid-filled microvacuoles that form within the matrix of intraocular lenses when exposed to an aqueous environment. The existence of glistening was first reported in polymethyl methacrylate (PMMA) lenses in 1985. The phenomenon of glistening is typically observed within a few months after surgery. Glistenings appear as small reflections of light during slit-lamp examination under oblique illumination. They are located within the network of the material of which the IOL is made and vary in size and density depending on the material. The formation of glistenings is influenced by a variety of factors including the IOL material, manufacturing processes, packaging and temperature fluctuations.Â
The EVOLUX lensâ„¢ provides an additional advantage, as it is made from a hydrophobic material that also ensures the transparency of the optics due to minimal glistening.Â
- Coassin M, Di Zazzo A, Antonini M, Gaudenzi D, Gallo Afflitto G, Kohnen T. Extended depth-of-focus intraocular lenses: power calculation and outcomes. J Cataract Refract Surg. 2020 Nov;46(11):1554-1560.
- Liu J, Dong Y, Wang Y. Efficacy and safety of extended depth of focus intraocular lenses in cataract surgery: a systematic review and meta-analysis. BMC Ophthalmol. 2019 Sep 2;19(1):198.
- Thomes BE, Callaghan TA. Evaluation of in vitro glistening formation in hydrophobic acrylic intraocular lenses. Clin Ophthalmol. 2013;7:1529-34. doi: 10.2147/OPTH.S44208. Epub 2013 Jul 25. PMID: 23926419; PMCID: PMC3732199.
- Sifi data being published